| NPI | 1568656916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI VAREBERG Business Manager 701-293-5429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-09-07 |